MEDICARE: MATTHEW E RUSEK MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208000000X	Pediatrics Physician	95885	SC

General Provider Information

NPI Number	:	1255043584
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MATTHEW E RUSEK MD

Provider Business Mailing Address
First Line	:	506 E CHEVES ST STE 202
Second Line	:
City	:	FLORENCE
State	:	SC
Zip	:	29506-2616
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3617 CASEY ST STE B
Second Line	:
City	:	LORIS
State	:	SC
Zip	:	29569-2981
Country	:	US
Telephone Number	:	843-716-8300
Fax Number	:	843-716-9792

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/19/2022
Last Update Date	:	02/13/2026

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Directions to “ MATTHEW E RUSEK MD” Practice Location

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